<%@ page language="java" contentType="text/html; charset=ISO-8859-1"
    pageEncoding="ISO-8859-1"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1">
<%@ include file="/title.html" %>
</head>
<body>
<table width="100%">
<%@ include file="/header.html" %>
<tr><td align="center" height="300px">
<table>
<tr><td align="center" height="40px" colspan="2" valign="top"><h3>Registration</h3></td></tr>
<% if(request.getAttribute("message") != null) { %>
<tr><td align="center" style="color:red" colspan="2" height="40px" valign="top"><%= request.getAttribute("message") %></td></tr>
<% } %>

<form name="signUp" action="SignUp" method="post">

<tr>
<td align="left">First Name:</td>

<td><input type="text" name="firstname" value="<%=request.getParameter("firstname")!=null?request.getParameter("firstname"):"" %>"></td>
</tr>
<tr>
<td align="left">Last Name:</td>
<td><input type="text" name="lastname" value="<%=request.getParameter("lastname")!=null?request.getParameter("lastname"):"" %>"></td>
</tr>
<tr>
<td align="left">Username: </td>
<td><input type="text" name="username" value="<%=request.getParameter("username")!=null?request.getParameter("username"):"" %>"></td>
</tr>
<tr>
<td align="left">Password: </td>
<td><input type="password" name="password" value=""></td>
</tr>
<tr>
<td align="left">Email Id: </td>
<td><input type="text" name="email" value="<%=request.getParameter("email")!=null?request.getParameter("email"):"" %>"></td>
</tr>
<tr>
<td align="left">Address: </td>
<td><textarea name="address"><%=request.getParameter("address")!=null?request.getParameter("address"):"" %></textarea></td>
</tr>
<tr>
<td align="left">City: </td>
<td><input type="text" name="city" id="city" value="<%=request.getParameter("city")!=null?request.getParameter("city"):"" %>"></td>
</tr>
<tr>
<td align="left">State: </td>
<td><select name="state" size="1">
       <option value=""></option>
	<option value="AL">Alabama</option>
	<option value="AK">Alaska</option>
	<option value="AZ">Arizona</option>
	<option value="AR">Arkansas</option>
	<option value="CA">California</option>
	<option value="CO">Colorado</option>
	<option value="CT">Connecticut</option>
	<option value="DE">Delaware</option>
	<option value="DC">Dist of Columbia</option>
	<option value="FL">Florida</option>
	<option value="GA">Georgia</option>
	<option value="HI">Hawaii</option>
	<option value="ID">Idaho</option>
	<option value="IL">Illinois</option>
	<option value="IN">Indiana</option>
	<option value="IA">Iowa</option>
	<option value="KS">Kansas</option>
	<option value="KY">Kentucky</option>
	<option value="LA">Louisiana</option>
	<option value="ME">Maine</option>
	<option value="MD">Maryland</option>
	<option value="MA">Massachusetts</option>
	<option value="MI">Michigan</option>
	<option value="MN">Minnesota</option>
	<option value="MS">Mississippi</option>
	<option value="MO">Missouri</option>
	<option value="MT">Montana</option>
	<option value="NE">Nebraska</option>
	<option value="NV">Nevada</option>
	<option value="NH">New Hampshire</option>
	<option value="NJ">New Jersey</option>
	<option value="NM">New Mexico</option>
	<option value="NY">New York</option>
	<option value="NC">North Carolina</option>
	<option value="ND">North Dakota</option>
	<option value="OH">Ohio</option>
	<option value="OK">Oklahoma</option>
	<option value="OR">Oregon</option>
	<option value="PA">Pennsylvania</option>
	<option value="RI">Rhode Island</option>
	<option value="SC">South Carolina</option>
	<option value="SD">South Dakota</option>
	<option value="TN">Tennessee</option>
	<option value="TX">Texas</option>
	<option value="UT">Utah</option>
	<option value="VT">Vermont</option>
	<option value="VA">Virginia</option>
	<option value="WA">Washington</option>
	<option value="WV">West Virginia</option>
	<option value="WI">Wisconsin</option>
	<option value="WY">Wyoming</option>
</select></td>
</tr>

<tr>
<td align="left">Zipcode: </td>
<td><input type="text" name="zipcode" id="zipcode" value="<%=request.getParameter("zipcode")!=null?request.getParameter("zipcode"):"" %>"></td>
</tr>

<tr>
<td align="left">Membership Type: </td>
<td> <INPUT TYPE="radio" NAME="Membertype" id="memtype" value="SC" CHECKED>
             Simple           <BR>
            <INPUT TYPE="radio" NAME="Membertype" id="memtype" value="PC">
            Premium
            <BR></td>
</tr>

<tr>
<td align="left">Credit Card Number: </td>
<td><input type="text" name="creditcardno" id="credit_no" value="<%=request.getParameter("creditcardno")!=null?request.getParameter("creditcardno"):"" %>"></td>
</tr>

<tr>
<td align="left">Credit Card Type: </td>
<td><SELECT id="creditcard_type" name="creditcard_type">
      <option value="Visa">Visa<option>
      <option value="Mastercard">Mastercard<option>
      <option value="American Express">American Express<option>
      </SELECT></td>
</tr>

<tr>
<td align="left">CVV Code: </td>
<td><input type="text" name="Cvvnumber" id="Cvvnumber" value=""></td>
</tr>

<!-- <tr>
                    <td>Expire Date (Month/Year):</td>
                    <td> 
                        <select name="month">
                            <% for(int i =1;i<=12;i++) {%>
                                <option value="<%=i%>"><%=i%></option>
                            <% } %>
                        </select>
                        <select name="year">
                            <% for(int i =2011;i<=2025;i++) {%>
                                <option value="<%=i%>"><%=i%></option>
                            <% } %>
                        </select>
                    </td>
                </tr>
 -->

<tr>
<td height="5px">
</td>
</tr>
<tr>
<tr>
<td colspan="2" align="center">
<input type="submit" name="register" value="Register">
<input type="reset" name="reset" value="Reset">
</td>
</tr>
</form>
<tr>
<td colspan="2" align="center">
<form name="cancel" action="signIn.jsp" method="post">
<input type="submit" name="cancel" value="Go Back and Sign In">
</form>
</td>
</tr>
</table>
</td>
</tr>
<%@ include file="/bottom.html" %>
</table>
</body>
</html>